title: Appearance distress and dysfunction in the elderly: international contrasts across Italy and the UK using DAS59.
abstract: BACKGROUND
  As the global population grows, the percentage of those over 60 will escalate disproportionately. Their needs will become an ever more dominant feature of public policy and healthcare provision. Older adults' appearance is often removed from cultural ideals and stereotypes of beauty, often seen as synonymous with "youth." This has seen older adults' concerns about appearance and body image somewhat sidelined in practice and in research. This study investigates the extent to which self-consciousness of appearance is associated with distress and dysfunction in those over 60 years old. Furthermore, we contrast the extent of this phenomenon in two European nations, UK and Italy, and consider the direct impact and interaction of cultural context and participant gender.
  
  
  METHODS
  To make an objective measurement of distress and dysfunction, we translated a widely used psychometric measure, the Derriford Appearance Scale 59 following an established and reliable translation protocol. Data were collected from community samples.
  
  
  RESULTS
  The Italian translation was sound, with acceptability in the Italian-speaking sample and acceptable internal consistency scores for full-scale and subscales. ANOVA analysis demonstrated that for overall adjustment, and all subscale scores, the Italians were more distressed about their appearance than UK comparators. Moreover, there were significant differences between Italian women and men, with Italian women more distressed than Italian men overall, and also general self-consciousness, sexual self-consciousness, and social self-consciousness subscales.
  
  
  CONCLUSIONS
  These results are considered in the context of aging and cultural and gender issues in appearance, including the Italian concept of bella figura.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Psychology, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK, tim.moss@uwe.ac.uk.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Moss
authors.forename: Annalisa
authors.initials: A
authors.lastname: Cogliandro
authors.forename: Maddalena
authors.initials: M
authors.lastname: Pennacchini
authors.forename: Vittoradolfo
authors.initials: V
authors.lastname: Tambone
authors.forename: Paolo
authors.initials: P
authors.lastname: Persichetti
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D000704:Analysis of Variance; D001504:Beauty; D001828:Body Image; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011594:Psychometrics; D012060:Rejuvenation / Q000502:physiology / Q000523:psychology; D018570:Risk Assessment; D017678:Sex Distribution; D015595:Skin Aging / Q000502:physiology; D012938:Social Perception; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom